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Nature of the Work
Pharmacists are stepping beyond the traditional delivery of prescriptions to become more involved in drug therapy decision-making and patient counseling.
Earnings are very high, but some pharmacists work long hours.
Pharmacists dispense drugs prescribed by physicians and other health practitioners and provide information to patients about medications and their use. They advise physicians and other health practitioners on the selection, dosages, interactions, and side effects of medications. Pharmacists must understand the use, composition, and effects of drugs. Compounding—the actual mixing of ingredients to form powders, tablets, capsules, ointments, and solutions—is only a small part of a pharmacist's practice, because most medicines are produced by pharmaceutical companies in a standard dosage and form.
Pharmacists in community (retail) pharmacies counsel patients, as well as answer questions about prescription drugs, such as possible adverse reactions and interactions. They provide information about over-the-counter drugs and make recommendations after asking a series of health questions, such as whether the customer is taking any other medications. They also give advice about durable medical equipment and home health care supplies. Those who own or manage community pharmacies may buy and sell nonhealth-related merchandise, hire and supervise personnel, and oversee the general operation of the pharmacy. Some community pharmacists offer specialized disease state management services for conditions such as diabetes, asthma, smoking cessation or high blood pressure.
Pharmacists in hospitals and clinics dispense medications and advise the medical staff on the selection and effects of drugs. They may make sterile solutions and buy medical supplies. They also assess, plan, and monitor drug regimens. They counsel patients on the use of drugs while in the hospital, and on their use at home when they are discharged. Pharmacists may also evaluate drug use patterns and outcomes in the hospital or in a patient population.
Pharmacists who work in home health care prepare infusions (solutions that are injected into patients) and other medications for use in the home, and monitor drug therapy.
Most pharmacists keep computerized records of patients' drug therapies to ensure that harmful drug interactions do not occur. They frequently teach pharmacy students serving as externs in preparation for graduation and licensure.
Some pharmacists specialize in specific areas, such as drugs for psychiatric disorders, intravenous nutrition support, oncology, nuclear pharmacy, or pharmacotherapy.
Pharmacists usually work in clean, well-lighted, and well-ventilated areas. Many pharmacists spend most of their time on their feet. When working with sterile or potentially dangerous pharmaceutical products, pharmacists wear gloves and masks and work with special protective equipment. Many community and hospital pharmacies are open extended hours or around the clock, so pharmacists may work evenings, nights, weekends, and holidays. Consultant pharmacists may travel to nursing homes or other facilities to monitor people's drug therapy.
About 1 out of 5 pharmacists worked part time in 1996. Most full-time salaried pharmacists worked about 40 hours a week. Some, including most self-employed pharmacists, worked more than 50 hours a week.
Pharmacists held about 172,000 jobs in 1996. About 3 out of 5 worked in community pharmacies, either independently owned, part of a drug store chain, or part of a grocery store, department store, or mass merchandiser. Most community pharmacists were salaried employees, but some were self employed owners. About one-quarter worked in hospitals, and others worked in clinics, mail-order pharmacies, pharmaceutical wholesalers, home health care agencies, or the Federal Government.
Some pharmacists hold more than one job. They may work a standard week in their primary work setting, and also work part time elsewhere.
A license to practice pharmacy is required in all States, the District of Columbia, and U.S. territories. To obtain a license, one must graduate from an accredited college of pharmacy, pass a State examination, and serve an internship under a licensed pharmacist. Most States grant a license without extensive reexamination to qualified pharmacists already licensed by another State3/4check with State boards of pharmacy for details. Many pharmacists are licensed to practice in more than one State. Most States require continuing education for license renewal.
At least 5 years of study beyond high school are required to graduate from programs accredited by the American Council on Pharmaceutical Education. A Bachelor of Science (B.S.) in Pharmacy, the degree received by most graduates, takes 5 years. A Doctor of Pharmacy (Pharm.D.) normally requires at least 6 years, during which an intervening bachelor's degree is usually not awarded. Those who already hold the bachelor's degree may enter Pharm.D. programs, but the combined period of study is usually longer than 6 years. In 1997, 79 colleges of pharmacy conferred degrees. The number of schools offering the Pharm.D. as the only professional degree increased to 41, and the number offering the B.S. in Pharmacy as the only professional degree continued to decline, reaching 4.
Requirements for admission to colleges of pharmacy vary. A few colleges admit students directly from high school. Most colleges of pharmacy, however, require 1 or 2 years of college-level prepharmacy education. Entry requirements usually include mathematics and basic sciences, such as chemistry, biology, and physics, as well as courses in the humanities and social sciences. Some colleges require the applicant to take the Pharmacy College Admissions Test.
All colleges of pharmacy offer courses in pharmacy practice, designed to teach students to dispense prescriptions, communicate with patients and other health professionals, and to strengthen their understanding of professional ethics and practice management responsibilities. Pharmacists' training increasingly emphasizes direct patient care, as well as consultative services to other health professionals.
Recently, pharmacy schools voted to move toward offering the Pharm.D. as the only professional degree in pharmacy. However, some schools continue to offer the B.S. in Pharmacy. All accredited pharmacy schools are expected to graduate their last B.S. class by the year 2004. Either degree currently fulfills the requirements to take the licensure examination of a state board of pharmacy.
The bachelor's degree in pharmacy is generally acceptable for most positions in community pharmacies, at least in the forseeable future. A growing number of hospital employers prefer that a pharmacist have a Pharm.D. degree. A master's or Ph.D. degree in pharmacy or a related field usually is required to do research, and a Pharm.D. with additional residency or fellowship training, master's, or Ph.D. usually is necessary for faculty positions.
In 1996-97, 60 colleges of pharmacy awarded the Master of Science degree or the Ph.D. degree. Although a number of pharmacy graduates interested in further training pursue an advanced degree in pharmacy, there are other options. Some enter 1- or 2-year residency programs or fellowships. Pharmacy residencies are organized, directed, postgraduate training programs in pharmacy practice. Pharmacy fellowships are directed, highly individualized programs designed to prepare participants to work in research laboratories.
Areas of graduate study include pharmaceutics and pharmaceutical chemistry (physical and chemical properties of drugs and dosage forms), pharmacology (effects of drugs on the body), and pharmacy administration, including pharmacoeconomics and social-behavioral aspects of patient care.
Prospective pharmacists should have scientific aptitude, good communication skills, and a desire to help others. They must also be conscientious and pay close attention to detail, because the decisions they make affect human lives.
In community pharmacies, pharmacists usually begin at the staff level. After they gain experience and secure the necessary capital, many become owners or part owners of pharmacies. Pharmacists in chain drug stores may be promoted to pharmacy supervisor or manager at the store level and then at the district or regional level, and later to an executive position within the chain's headquarters.
Hospital pharmacists may advance to supervisory or administrative positions. Pharmacists in the pharmaceutical industry may advance in marketing, sales, research, quality control, production, packaging, and other areas.
Employment of pharmacists is expected to grow as fast as the average for all occupations through the year 2006, due to the increased pharmaceutical needs of a larger and older population, and greater use of medication. Cost-conscious insurers and health systems will continue to emphasize the role of pharmacists in primary and preventive health services. They realize that the expense of using medication to treat diseases and conditions is often considerably less than the potential costs for patients whose conditions go untreated, and pharmacists can also play an important role in reducing the expenses resulting from unexpected complications due to allergic reactions or medication interactions.
The increased number of middle aged and elderly people will spur demand for pharmacists in all practice settings. The number of prescriptions influences the demand for pharmacists, and the middle aged and elderly population uses more prescription drugs, on average, than younger people.
Other factors likely to increase the demand for pharmacists through the year 2006 include the likelihood of scientific advances that will make more drug products available, new developments in administering medication, and increasingly sophisticated consumers seeking more information about drugs.
Employment in hospitals is expected to grow slowly, as hospitals reduce inpatient stays, downsize, and consolidate departments. Pharmacy services are shifting to long-term, ambulatory, and home care settings, where opportunities for pharmacists will be best. New opportunities for pharmacists are emerging in managed care organizations, where pharmacists analyze trends and patterns in medication use for their populations of patients. Fast growth is also expected for pharmacists employed in research, disease management, and pharmacoeconomics—determining the costs and benefits of different drug therapies.
Because of efforts to control prescription drug costs, retail pharmacies are taking steps to increase their prescription volume to make up for declining dispensing fees. Automation of drug dispensing and greater use of pharmacy technicians will help them dispense more prescriptions. The number of community pharmacists needed in the future will depend on the expansion rate of chain drug stores and the willingness of insurers to reimburse pharmacists for providing clinical services to patients taking prescription drugs. With its emphasis on cost control, managed care has encouraged the growth of lower-cost distributors of prescription drugs such as mail-order firms. Slower employment growth is expected in traditional chain and independent pharmacies.
Median weekly earnings of full-time, salaried pharmacists were $992 in 1996. Half earned between $827 and $1,177. The lowest 10 percent earned less than $554 and the top 10 percent more than $1,422.
According to a survey by Drug Topics magazine, published by Medical Economics Inc., average base salaries of full-time, salaried pharmacists were $59,276 per year in 1996. Pharmacists working in chain drug stores had an average base salary of $61,735 per year, while pharmacists working in independent drug stores averaged $52,189, and hospital pharmacists averaged $61,317. Overall, salaries for pharmacists were highest in the West and second highest in the East. Many pharmacists also receive compensation in the form of bonuses, overtime, and profit-sharing.
Persons in other professions who may work with pharmaceutical compounds are pharmaceutical chemists, pharmacologists, medical scientists, and biological technicians.
For information on pharmacy as a career, preprofessional and professional requirements, programs offered by all the colleges of pharmacy, and student financial aid, contact:
American Association of Colleges of Pharmacy, 1426 Prince St., Alexandria, VA 22314.
Information on requirements for licensure in a particular State is available from the State board of pharmacy.
Information on specific college entrance requirements, curriculums, and financial aid is available from the dean of any college of pharmacy.
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